Caregiver burden and the medical ethos

Abstract

Are physicians sometimes morally required to ease caregiver burden? In our paper we defend an affirmative answer to this question. First, we examine the well-established principle that medical care should be centered on the patient. We argue that although this principle seems to give physicians some leeway to lessen caregivers' suffering, it is very restrictive when spelled out precisely. Based on a critical analysis of existing cases for transcending patient-centeredness we then go on to argue that the medical ethos should indeed contain a rule requiring physicians to alleviate caregiver burden under certain circumstances. Finally, we apply our findings to deep brain stimulation (DBS) for Parkinson's disease. We present empirical data from a recent study of DBS indicating that spousal caregivers of Parkinson patients treated with DBS are sometimes deeply troubled by the effects of the therapy and discuss what moral obligations the treating physicians may have in such cases.

Caregiver Burden in Adults With Inflammatory Bowel Disease

“…Traditionally, the approach to patient care has been one of patientcenteredness and, thus, in the strictest interpretation of this method, caregiver burden would fall outside the purview of the patient-physician relationship. However, in an article by Witt et al, 46 the investigators argued that expanding the focus of care to include caregivers ultimately benefits the patient and still fits within the medical ethos of providing patient-centered care. Caregivers are crucial to improving the health of a chronically ill patient, and a healthy caregiver who is equipped with adaptive coping strategies can better support a patient and enhance their health outcomes than a caregiver who is burdened excessively by this task.…”

“…Especially relevant to spousal caregivers, some interventions in cancer survivors have been designed to target both partners with the goal of enhancing relationship adjustment and the ability to engage in shared coping with the disease. 49,50 Psychological distress (eg, depression/anxiety, guilt) 10,46,58 Decline in physical health 31 Sleep disturbances 58 Changes in lifestyle (inability to exercise, follow nutritious diet) 58 Social isolation 7,10,58 Missed hours at work or decreased productivity at work 20 Strain on interpersonal relationship with caregivers 8 Medication/treatment plan nonadherence 26 Psychological distress (eg, depression/anxiety) 10 Modalities to Address Caregiver Burden…”

The Experience of Working With a Faith Community Nurse Liaison of Care in a Primary Care Practice Among Older Adult Clients and Their Informal Caregiver

“…Caregiver stress and burden occur when there is an imbalance between self-care and the physical, mental, emotional, social, spiritual, and financial demands of caregiving (Chen et al, 2015;Lai et al, 2018;Longacre et al, 2017;Poku, 2015;Witt et al, 2017). As reflected in the literature, caregivers in this study described caregiving as a straining, challenging, and frustrating hardship.…”

Bringing Advanced Therapies for Parkinson’s Disease to the Clinic: An Analysis of Ethical Issues

“…PD implies emotional, cognitive and personality changes, influencing the patient’s behaviour in daily situations [ 23 ] which affects caregivers. For example, neuropsychiatric symptoms (impulsivity, hypomania [ 14 ]) resulting from DBS contribute to burden on caregivers [ 24 ] who are sometimes deeply troubled by the effects of this therapy [ 25 ].…”